Regional histologic differences in the long head of the biceps tendon following subpectoral biceps tenodesis in patients with rotator cuff tears and SLAP lesions

Background: Biceps tenodesis may be performed for symptomatic tendinopathy or tearing of the long head of the biceps tendon. Biceps tenodesis is also commonly performed as an adjunctive procedure. However, the indications and prevalence of biceps tenodesis have expanded. Purpose: To establish the incidence and risk factors for revision biceps tenodesis. Study Design: Case-control study; Level of evidence, 2. Methods: The PearlDiver database of Humana patient data was queried for patients undergoing arthroscopic or open biceps tenodesis (Current Procedural Terminology [CPT] 29828 and CPT 23430, respectively) from 2008 through the first quarter of 2017. Patients without a CPT laterality modifier were excluded from analysis. Revision biceps tenodesis was defined as patients who underwent subsequent ipsilateral open or arthroscopic biceps tenodesis. The financial impact of revision biceps tenodesis was also calculated. Multivariate binomial logistic regression was performed to identify risk factors for revision biceps tenodesis, such as patient demographics as well as concomitant procedures and diagnoses. Odds ratios (ORs) and 95% CIs were calculated, and all statistical comparisons with P < .05 were considered significant. Results: There were 15,257 patients who underwent biceps tenodesis. Of these, 9274 patients (60.8%) underwent arthroscopic biceps tenodesis, while 5983 (39.2%) underwent open biceps tenodesis. A total of 171 patients (1.8%) and 111 patients (1.9%) required revision biceps tenodesis after arthroscopic and open biceps tenodesis, respectively ( P = .5). Male sex (OR, 1.38 [95% CI, 1.04-1.85]; P = .02) was the only independent risk factor for revision biceps tenodesis after the index open biceps tenodesis. After arthroscopic biceps tenodesis, age >45 years (OR, 0.58 [95% CI, 0.39-0.89]; P = .01) and concomitant rotator cuff tear (OR, 0.58 [95% CI, 0.47-0.71]; P < .001) were independent protective factors for revision biceps tenodesis. The total cost of revision biceps tenodesis after open and arthroscopic biceps tenodesis was US$3427.95 and US$2174.33 per patient, respectively. Conclusion: There was no significant difference in the revision rate between arthroscopic and open biceps tenodesis. Risk factors for revision surgery included male sex for open biceps tenodesis, while age >45 years and rotator cuff tears were protective factors for arthroscopic biceps tenodesis.

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A meta-analysis comparing tenotomy or tenodesis for lesions of the long head of the biceps tendon with concomitant reparable rotator cuff tears

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1429-x ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Yuyan Na ◽

Yong Zhu ◽

Yuting Shi ◽

Yizhong Ren ◽

Ting Zhang ◽

...

Keyword(s):

Rotator Cuff ◽

Constant Score ◽

Biceps Tendon ◽

Meta Analysis ◽

Risk Of Bias ◽

Rotator Cuff Tears ◽

Biceps Tenodesis ◽

Biceps Tenotomy ◽

Long Head ◽

Supination Strength

Abstract Background The best treatment for lesions of the long head of the biceps tendon (LHBT) with concomitant reparable rotator cuff tears is still controversial. The purpose of the meta-analysis was to compare clinical outcomes of biceps tenotomy and tenodesis for LHBT lesions. Methods A literature retrieval was conducted in MEDLINE, Embase, and Cochrane Library from 1979 to March 2018. Comparative studies (level of evidence I or II) comparing tenotomy and tenodesis for LHBT lesions with concomitant reparable rotator cuff tears were included. Risk of bias for all included studies was assessed using the Cochrane Collaboration’s risk of bias tool. Clinical outcomes compared were Popeye sign, Constant score, VAS pain score, cramping pain, elbow flexion and forearm supination strength, and re-tear of the rotator cuff. Results Two randomized controlled trials (RCTs) and five prospective cohort studies (PCS) with 288 biceps tenotomy patients and 303 biceps tenodesis patients were included in this review. Tenotomy resulted in significantly greater rates of Popeye sign (RR, 2.70 [95% CI, 1.80 to 4.04]; P < 0.01) and a less favorable Constant score (MD, − 1.09 [95% CI, − 1.90 to − 0.28]; P < 0.01) compared to tenodesis. No significant heterogeneity was found between the two groups across all parameters except forearm supination strength. Conclusions The current evidence indicates that biceps tenodesis for LHBT lesions with concomitant reparable rotator cuff tears results in decreased rate of Popeye sign and improved Constant score compared to biceps tenotomy. Trial registration PROSPERO, CRD42018105504. Registered on 13 August 2018.

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Classification and analysis of pathology of the long head of the biceps tendon in complete rotator cuff tears

Biomedical Journal ◽

10.4103/2319-4170.106145 ◽

2012 ◽

Vol 35 (3) ◽

pp. 263 ◽

Cited By ~ 2

Author(s):

Chih-Hwa Chen ◽

Chih-Hsiang Chang ◽

Chun-I Su ◽

Kun-Chung Wang ◽

I-Chun Wang ◽

...

Keyword(s):

Rotator Cuff ◽

Biceps Tendon ◽

Rotator Cuff Tears ◽

Long Head

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Long Head of the Biceps Pathology Combined with Rotator Cuff Tears

Advances in Orthopedics ◽

10.1155/2012/405472 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Konstantinos Ditsios ◽

Filon Agathangelidis ◽

Achilleas Boutsiadis ◽

Dimitrios Karataglis ◽

Pericles Papadopoulos

Keyword(s):

Rotator Cuff ◽

Biceps Tendon ◽

Treatment Strategies ◽

Close Correlation ◽

Current Treatment ◽

Rotator Cuff Tears ◽

Anatomic Structure ◽

Long Head ◽

Diagnosis Classification ◽

Shoulder Pathologies

The long head of the biceps tendon (LHBT) is an anatomic structure commonly involved in painful shoulder conditions as a result of trauma, degeneration, or overuse. Recent studies have pointed out the close correlation between LHBT lesions and rotator cuff (RCT) tears. Clinicians need to take into account the importance of the LHBT in the presence of other shoulder pathologies. This paper provides an up-to-date overview of recent publications on anatomy, pathophysiology, diagnosis, classification, and current treatment strategies.

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